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NPI Code Detail

MEDICARE: JANNETT JULIA HERNANDEZ MSW,LSW

MEDICARE: JANNETT JULIA HERNANDEZ MSW,LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker1801936OH

General Provider Information

NPI Number : 1962909424
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANNETT JULIA HERNANDEZ MSW,LSW
Provider Business Mailing Address
First Line : 1227 CENTRAL AVE
Second Line :
City : MIDDLETOWN
State : OH
Zip : 45044-4103
Country : US
Telephone Number : 513-737-1247
Fax Number :
Provider Business Practice Location Address
First Line : 1227 CENTRAL AVE
Second Line :
City : MIDDLETOWN
State : OH
Zip : 45044-4103
Country : US
Telephone Number : 513-737-1247
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2018
Last Update Date : 04/11/2018

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